The two trauma-focused CBT approaches are based on the theory that negative emotions connected to the memories for the traumatic event and how the person thinks about the traumatic event lead to PTSD. The tow therapies take different approaches to reducing PTSD, but both work equally well.  

Prolonged Exposure (PE).  PE focuses on reducing the intense negative emotions that are caused by memories or being reminded of the trauma.  The main negative emotions that got with remembering are fear and shame.  The idea is that facing up to the memory in a planned way eventually wears down the negative emotions connected to the memory so that remembering or being reminded is not so upsetting.  When the memory or reminders are not so upsetting, the person does not have to avoid them and can have a more normal life. W

Cognitive Processing Therapy (CPT).  CPT focuses mainly on unrealistic and unhelpful thoughts a person has about the trauma.  These thoughts can cause memories or reminders of the trauma to be very upsetting because thoughts can lead to intense negative feelings such as fear or shame.  The idea is to identify and change the thoughts in a planned way.  When the person thinks in a more realistic and helpful way, remembering or being reminded is not so upsetting and the person can return to a normal life.  

Trauma-focused CBT often gets results in a few months. Sometimes the person does not even need a whole course of therapy to be better.  Other times, especially for more severe or long lasting traumas or where there is a past history of trauma, it can take longer.

The key is that therapy works because the person is actively trying to change in between therapy sessions.  The two main elements of effective trauma-focused therapy are practicing facing up to fears or practicing substituting in new and more helpful thoughts.  It is hard work, but it is really worth it.  The therapist is there to help you succeed. 

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